Category Archives: ETS

PHAI Urges HUD to Expand Proposed Smoke-free Public Housing Rule to All HUD-Funded Housing

The Public Health Advocacy Institute submitted comments to a proposed rule by the U.S. Department of Housing and Urban Development (“HUD”) to make its public housing smoke-free. The proposed rule would affect 1.1 million households, but leave 3.4 million other HUD-funded households unprotected.  These include the agency’s tenant-based and project-based rental assistance.

PHAI argues that there is are several ways that HUD could expand the proposed protections:

  • HUD maintains significant control over the development and operation of many mix financed properties, in part, through the Housing Assistance Payment Contracts. HUD has a legal right to change these contracts during the renewal process.  Going smoke-free could simply become part of the eligibility requirements, for example, under the all HAP contract renewals going forward. Just like it currently prohibits marijuana use in all the housing it finances, HUD could require a smoke-free environment, too.
  • There is widespread support for smoke-free policies among owners and property management companies of mix-financed, affordable properties. In Massachusetts, some of the leading management companies of mixed financed affordable properties have made many, and in some cases all, of their properties smoke-free. Examples include Beacon Communities, Peabody Properties, and Corcoran Management.
  • Surveys show that residents who are eligible for affordable housing prefer a smoke-free building, despite the high smoking rates in affordable housing.
  • Smoke-free rules reduce maintenance costs, which would benefit the private owners and funders of affordable housing.
  • The health and safety risk to residents exposed to drifting secondhand smoke is the same regardless of whether the resident lives in public housing or another type of affordable housing.
  • Requiring smoke-free buildings for the use of tenant-based assistance would cause approximately 700,000 landlords to go smoke-free.  This change would benefit all residents living at these properties, not just the voucher holders.

Download our comments here.

PHAI operates the Commonwealth of Massachusetts’s Smokefree Housing Program as well as the Public Health and Tobacco Policy Center, which provides services, including smoke-free housing legal and policy technical assistance, to entities funded by the New York State Bureau of Tobacco Control.

PHAI’s Chris Banthin Quoted in Boston Globe Article on Smokefree Homes

banthinThe April 30th edition of the Boston Globe featured an article authored by correspondent Peter Keogh entitled: “The Plight of the Smoking Man.”

The piece explained the difficulties that some smokers have faced in the wake of increasing restrictions on smoking, including in many multiunit residential buildings.  While the article spends some time exploring the perspective of members of a Cambridge-based smokers’ rights group, it gave the final word to PHAI’s Chris Banthin, who directs the Tobacco Control Resource Center at PHAI.  Most of Mr. Banthin’s time is devoted to educating landlords, tenants, condominium associations, and property management companies why and how to successfully implement smokefree policies through the Massachusetts Smokefree Housing Project.

This excerpt of the article includes Mr. Banthin’s response to some of the concerns raised by the smokers’ rights group members:


Chris Banthin is a lawyer working with Northeastern University’s Public Health Advocacy Institute . In a 2013 interview with WBUR, Helfer, the smokers’ rights group cofounder, describes the institute’s Tobacco Control Resource Center as “public health absolutists [who] feel that if we all do what they tell us to do, we’re going to have some kind of utopian state.”

Banthin, however, describes it as “an organization that seeks to use the law to improve public health.”

When it comes to regulating smoking in privately owned properties, Banthin sees no pressing need for legislation. “A lot of landlords are going smoke-free voluntarily,” he says. “Condos also. It’s a selling point.”

But aren’t they trespassing on the right to do what you want in your own home? Aren’t the restrictions more moralistic than a valid response to any health threat?

“Those arguments fall flat,” Banthin says. “If we accept the premise that landlords can do with their property as they wish, the argument is inconsistent. And if you have the right to do what you want in your home, shouldn’t your neighbor have the same right? Your right to do what you want stops at your neighbor’s nose.

“As for secondhand smoke, the science is 100 percent irrefutable and widely accepted.”

Banthin sympathizes with those affected by bans. He advises landlords and other stakeholders on how to implement a no-smoking rule. Part of that includes engaging residents in the process.

“I have gone to hundreds of housing authority meetings,” he says. “I’m the first one that tells them. Most of them are upset, but most say, ‘OK, I recognize it’s important, so I’ll go outside.’ I think everybody gets it.”

PHAI publishes new resource:

PHAI has just published a new website consisting of searchable summaries of over 600 secondhand smoke lawsuits based in the United States.  The cases stretch back to the 1970s and the data was most recently updated in July, 2013.  We will continue to update the site and add new cases as well as indicate developments in existing cases.

The project is the work of our Senior Attorney Edward Sweda, who began compiling “Ed’s List” about 25 years ago.  The list has been published in the Tobacco Products Litigation Reporter and used by many tobacco control organizations and individuals seeking legal redress to smoke exposure problems.  The project would not have made it to the web but for the efforts of our summer intern, Rebecca Leff, who copied and formatted a 133 page single spaced document to create 628 case entries.

The site is searchable by type of case, e.g., custody disputes, real property, smoking in prisons, or litigation against tobacco companies, as well as the state where the action was filed.


PHAI’s Gottlieb co-authors new study showing increased tobacco smoke expsoure of kids in multi-unit housing

Today, Wilson et al., published a new study in the journal Pediatrics demonstrating that children who live in homes in which no one smokes inside have a 45% increase in cotinine levels if they live in apartments compared with detached homes. The findings came through analysis of data from the 2001–2006 National Health and Nutrition Examination Survey.

What this means is that it is likely that tobacco smoke from other units in attached housing results in tobacco smoke exposure for residents of “non-smoking” units.  Because there is no risk-free level of tobacco smoke exposure, there are several policy implications here:

  1. Potential residents of multi-unit housing should carefully check a building’s smoking policy before moving in because there is no such thing as a smoke-free home if there is smoking in the building;
  2. Landlords need to understand that a permissive smoking policy means more than increased fire risk and maintenance costs and should act accordingly; and
  3. While we may all respect the privacy rights associated with the home, tobacco smoke does not.

This study provides important evidence that the growing trend in smoke-free housing, besides enhancing property values, reducing fire risks and lowering maintenance costs, makes the home a safer place or everyone, particularly children and others who spend the most time indoors such as the elderly and disabled.

PHAI Addresses tobacco industry’s use of corporate social responsibility tactics and personal responsibility rhetoric

On June 29, 2010, the Public Health Advocacy Institute conducted a webinar on the tobacco industry’s use of corporate social responsibility rhetoric and tactics to try to improve its image, while still maintaining an emphasis on personal responsibility.

Tobacco companies use corporate social responsibility rhetoric and tactics to normalize their image and stave off further regulation and litigation by appearing to have improved their corporate behavior.  Simultaneously, the industry uses the theme of personal responsibility to shift the onus for tobacco products’ impact away from itself and back to the public.

A 60 minute Webinar entitled Tag! You’re It: How Big Tobacco Shifts Blame Back Onto the Public was broadcast on June 29, 2010 and is archived here. Power Point slides from the webinar are available here in PDF format.

Please check out our Issue Briefs here:


Topics covered by the webinar and issue briefs include:

  • How the tobacco industry has strategically used corporate social responsibility rhetoric and tactics to normalize and improve its image and stave off further regulation and litigation.
  • How the tobacco industry uses personal responsibility rhetoric to shift the onus for public health from corporations back to the public.
  • Examples of specific programs and campaigns that have been used to shift blame from the industry to the public.

The tobacco industry uses various corporate social responsibility programs to convince the public that it has changed and become more responsive to concerns about health and its products’ negative impact on society.

For instance, under the guise of corporate social responsibility, the tobacco companies run “youth smoking prevention” programs to appear as if they are combating youth smoking, but in reality, tobacco companies deny that their pernicious, vigorous marketing has any effect on creating the problem and instead focus solely on putting more responsibility on parents and children.  These programs have been found to be ineffective in preventing or diminishing youth smoking, perhaps by design, but they do introduce another generation of smokers to a tobacco industry with an improved image.

The industry’s secondhand smoke PR campaigns denied the inherent dangers of exposure to its products and instead made the issue one of “courtesy” and “accommodation,” once again shifting the responsibility away from the manufacturers to consumers and the general public.  Tobacco control advocates can use these findings to denormalize the tobacco industry through counter-marketing campaigns and to deny it the legitimacy it seeks through its corporate social responsibility shell game.

Tobacco company sponsored smoking cessation information programs try to shift the responsibility to smokers, most of whom became addicted to their products as children.  Meanwhile, the companies never discuss any efforts to make their products less addictive.

PHAI’s Gottieb co-authors piece in NEJM: Puffing in public housing poses serious health risks to tenants

Media contacts: Valerie Wencis, Massachusetts General Hospital, 617.726.0274,

Todd Datz, Harvard School of Public Health, 617.998.8819,

Barry Wanger, Northeastern University School of Law, 617.965.6469,

Researchers examine risks and consequences of cigarette smoking to all inhabitants of multiple-unit housing; challenge status quo

BOSTON– In an effort to protect children from harmful tobacco smoke exposure, health and medical professionals are pushing for a ban on smoking in public housing in a report appearing in this week’s New England Journal of Medicine.

“Research shows that those living in multiple-unit housing are being exposed to toxins from tobacco smoke,” says Jonathan Winickoff, MD, MPH, lead author and pediatrician at MassGeneral Hospital for Children (MGHfC).  “Even if you are not a smoker and don’t smoke inside of your own apartment, if you have a neighbor who is smoking inside of his, the entire building is contaminated.”

Over 7 million people are served by public housing in the U.S., with 4 in 10 units occupied by families with children.  On July 17, 2009, the U.S. Department of Housing and Urban Development (HUD) issued a memorandum that strongly encouraged local Public Housing Authorities (PHAs) to implement no-smoking policies in some or all of their public housing units.  While surveys indicate that 4 in 5 nonsmokers prefer smoke-free building policies, and many private landlords throughout the country have made their housing units smoke-free, only about 4% of PHAs have banned smoking in the units they manage. The article gives specific guidance on policy options for PHAs and HUD to protect all residents from tobacco smoke exposure and clarifies that there are no legal barriers to banning smoking in public housing. “HUD has taken an important step,” says coauthor Michelle Mello, J.D., Ph.D. of the Harvard School of Public Health, “but it could do more to prod lagging PHAs to take action.”

The National Toxicology Program has identified more than 250 poisonous gases, chemicals, and metals in tobacco smoke, 11 of which are class A carcinogens. Numerous epidemiologic studies show that exposure to tobacco smoke can cause lung cancer and cardiac disease in nonsmokers, and the Surgeon General’s report on involuntary smoking concluded that there is no safe level of exposure.  Even brief exposures to tobacco smoke can adversely affect nonsmokers, especially children, who experience increased rates and severity of asthma and other respiratory illnesses, as well as higher risk of sudden infant death syndrome.

Smoking in a single unit within a multiunit residential building puts other residents of the building at risk.  Tobacco smoke can move along air ducts, through cracks in the walls and floors, through elevator shafts, and along plumbing and electrical lines to affect units on other floors.  Mitigation measures like fans and air filters are not effective in preventing exposure. High levels of tobacco toxins can persist in the indoor environment long after the period of active smoking — a phenomenon known as third-hand smoke.  Tobacco toxins from smoke are deposited on indoor surfaces and reemitted in the air over a period of days to years, and are found on rugs, furniture, clothing, and floors – all surfaces that children crawl and play on.

While it is clear that second and third hand smoke are inimical to the health of nonsmokers in multiple housing units, there are challenges facing public housing authorities, landlords and nonsmokers.  Any addiction is difficult to overcome and a ban would put pressure on tenants addicted to nicotine, and could raise concern over how to deal with tenants who continued to smoke inside their building.

“Any no-smoking policies within PHAs would need to be accompanied by clear instructions on how residents can access evidence-based smoking-cessation resources,” says coauthor Mark Gottlieb, J.D., Executive Director of the Public Health Advocacy Institute at Northeastern University School of Law.  Currently most state Medicaid programs do not cover comprehensive tobacco-dependence treatments, a situation that may change with an increased emphasis on tobacco control in healthcare reform. However, right now, free smoking cessation services are available in all 50 states though the quitline.

“Rather than prohibiting smokers from inhabiting public housing units, prohibiting the act of smoking on the premises would minimize the ethical concerns relating to a smoking ban,” says Mello.   “This type of policy would encourage smokers to quit, since only those who continued to smoke on the premises would be required to move out.”

Creating and maintaining smoke-free living space that encourages smoking cessation not only provides a healthy environment for children as they grow, it discourages them from picking up the habit.  “When children see smoking in and around their homes, it normalizes the behavior for them,” says Mello.  “Research shows that no-smoking policies in the home lead to lower smoking initiation rates by teens.”  Americans living below the poverty level are 1.6 times more likely to smoke; adopting a smoke-free policy in public housing units encourages inhabitants to “fight back” against the intense tobacco marketing that exists in low-income neighborhoods.

“As we move forward and further explore public housing policy, it is important to remember that the status quo is not acceptable for America’s children,” says Winickoff.  “Each child deserves a healthy start, and we can help provide this by encouraging smoke-free home environments.”

About the Massachusetts General Hospital

Founded in 1811, the MGH is the third oldest general hospital in the United States and the oldest and largest in New England. The 900-bed medical center offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. Each year the MGH admits more than 46,000 inpatients and handles nearly 1.5 million outpatient visits at its main campus and health centers. Its Emergency Department records nearly 80,000 visits annually. The surgical staff performs more than 35,000 operations and the MGH Vincent Obstetrics Service delivers more than 3,500 babies each year. The MGH conducts the largest hospital-based research program in the country, with an annual research budget of more than $500 million. It is the oldest and largest teaching hospital of Harvard Medical School, where nearly all MGH staff physicians serve on the faculty. The MGH is consistently ranked among the nation’s top hospitals by US News and World Report.

About Harvard School of Public Health

Harvard School of Public Health ( ) is dedicated to advancing the public’s health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit:

About The Public Health Advocacy Institute

The Public Health Advocacy Institute (PHAI) is a legal research center at Northeastern University School of Law that focuses on public health law. PHAI’s goal is to support and enhance a commitment to public health in individuals and institutes who shape public policy through law.  PHAI is committed to research in public health law, public health policy development; to legal technical assistance; and to collaborative work at the intersection of law and public health. 


PHAI Attorney Chris Banthin Appears on WGBH with Boston Mayor Tom Menino to Discuss Smokefree Public Housing

The City of Boston is taking a leadership role in making public housing smokefree.  Today, PHAI’s Chris Banthin appeared on a panel with Boston mayor Tom Menino on WGBH FM’s Callie Crossley Show to discuss why smokefree public housing is the right thing to do.  Chris directs the Massachusetts Smoke-Free Housing Project. Listen to the broadcast here.

PHAI Publishes Issue Briefs on Tobacco Industry’s Corporate Makeover


The Public Health Advocacy Institute, supported by the American Legacy Foundation, has completed a year of research on the tobacco industry’s attempted corporate makeover, and has created five issue briefs on the topic.  A 60 minute Webinar was broadcast on May 11, 2009 and is archived HERE.  They highlight various aspects of the tobacco industry’s use of corporate social responsibility rhetoric and tactics to attempt to rehabilitate its image and fend off tobacco control activism.  These briefs each contain issues, the evidence and possible messages for State Tobacco Control Programs to use in their interventions and counter-marketing campaigns, and to generate support for future interventions.  The issue briefs can be used effectively to denormalize the tobacco companies and better understand the motives behind their corporate makeover attempts.

Issue Brief Topics:

  1. Corporate Social Responsibility Overview
  2. Manipulating Science
  3. Manipulating the Press
  4. Manipulating the Public and Regulators
  5. Youth Smoking

All briefs are in PDF format. get_adobe_reader1

PHAI RELEASES LIFE WITHOUT SMOKE: NEW SURVEY REVEALS STRONG DEMAND FOR SMOKE-FREE HOUSING – Owners indicate growing interest and value in making properties

Since 2004 when Massachusetts passed the smoke free workplace law, all public places and the vast majority of workplaces have been smoke free.  However, those living in multiunit dwellings, like apartment buildings and condominiums, are sometimes exposed to secondhand smoke drifting in from a neighboring unit.  The US EPA classifies secondhand smoke as a Human (Group A) Carcinogen, with no safe level of exposure and the Massachusetts Department of Public Health has noted an increase in the number of complaints on involuntary exposure in the home.

Recent surveys conducted by the Public Health Advocacy Institute (PHAI) at the Northeastern University School of Law show a high demand for smoke-free policies among residents.  PHAI is working with the Massachusetts Department of Public Health to encourage the voluntary implementation of building-wide smoke free rules in multiunit dwellings.

Click here for full survey results.

“There’s a great demand for smoke-free housing,” said Chris Banthin, Director of PHAI.    “Whether or not to go smoke-free is a decision for the residents and owners of multiunit dwellings.  Our role is to give residents and owners the information they need to make an informed decision.”

The survey of 1,300 residents of multiunit dwellings yielded the following key findings:

  • Of the residents who currently live in a smoke-free multi-unit building, 91% support the rule. Just 2% are opposed.
  • 81% of prospective residents are immediately less interested in an apartment or condominium unit if they smell tobacco smoke when looking at it.
  • 75% of residents who do not currently live in a smoke-free building would support the immediate implementation of a no smoking rule or remain neutral.
  • 69% of residents of multi-unit properties are more interested in knowing up front, in the property listing that an apartment or condominium unit is located in smoke-free building. Fewer than 20% feel this listing information would make no difference in their decision.
  • The levels of support and demand are widely held, remaining consistent across gender, age, educational status, income level and housing type.

The survey of 300 owners of residential rental properties found the following key findings:

  • 99% of the landlords who had implemented a smoke-free rule felt it was a good decision.
  • 90% of the landlords who had implemented a smoke-free rule reported that implementation was easy or very easy.
  • 93.3% of the owners who had implemented a smoke-free rule reported that the rule was virtually self-enforcing, the same as enforcing any other rule or easy to enforce.
  • 66% of the owners reported having to pay $100 or more extra in smoking-related maintenance costs per apartment compared to an apartment where smoking was not allowed. 33% expended more than $500 extra per unit.
  • 78% of the owners who had implemented a smoke-free rule reported no effect on vacancy or turnover rates.

A no smoking rule is an effective way to protect residents from exposure to secondhand smoke, according to the PHAI.  PHAI provides education as well as technical and legal guidance directly to owners and residents across the entire spectrum of housing types.  Those who smoke are welcome in smoke free properties, they are just asked to smoke outside so that their neighbors are not exposed to this health hazard.

The US EPA classifies secondhand smoke as a Human (Group A) Carcinogen, with no safe level of exposure.  This is the same category as Asbestos, Benzene and other highly toxic substances.  Exposure to secondhand smoke is the third leading preventable cause of death in Massachusetts.

The resident survey included 1,304 telephone interviews with residents of multi-unit properties in Amherst, Cambridge, Brookline, Easthampton, Hadley, Jamaica Plain, Newton, Northampton, Somerville, Southampton and Watertown.  The questionnaire screened respondents to ensure that they resided in a multi-unit rental property or condominium before asking questions designed to measure demand for smoke-free rules.  The owner survey included 300 written questionnaires completed by respondents in the same communities as the resident survey.

In conjunction will local health departments, he Public Health Advocacy Institute will be holding free meetings in Brookline, Cambridge, and Northampton, MA  to give basic legal advice, provide sample lease and condominium documents, and share the latest market research on the demand for smoke-free properties. Q&A sessions will follow each presentation.

The dates and times are:

May 4, 2009
Brookline Library (see printable information for this event)
6:30pm-7:30pm; 7:30pm-8:30pm

May 6, 2009
Brookline Health Department
10am-11am; 11am-12noon; 2om-3pm; 3:30pm-4:30pm

May 18, 2009
Cambridge, Cambridge Health Alliance’s Windsor Street Clinic
6pm-7pm; 7:30pm-8:30pm

May 20, 2009
Cambridge, Cambridge Health Alliance’s Windsor Street Clinic
1:30pm-2:30pm; 3pm-4pm

June 10, 2009
Northampton, Forbes Library
1pm-2pm; 5:30pm-6:30pm; 7pm-8pm

For more information on the issue, visit:

Note:  The Massachusetts Department of Public Health and the Public
Health Advocacy Institute have developed guides on how to implement a
smoke-free rule in condominiums and residential rental properties. The guides
are available at